A while back, I published an article, Are Pull-ups THAT Essential?, that was the single most popular in the history of EricCressey.com. One particularly important point I made was that chronically driving the scapulae into depression with overuse of the lats could lead to various injuries in lifters and athletes.
In the comments section after the article, one reader had a great question along these lines: Isn't benching with a big arch and cueing "down and back" with the shoulder blades during a bench press the exact same thing? Shouldn't the feet be up on the bench to get people out of extension?
I think it is a similar thing, but not the exactsame thing. And, I am not a fan of bench pressing with the feet up on the bench.
Before I get into the details of why, though, we should make an important differentiation between "gym" bench press technique and the bench press technique used by competitive powerlifters in competition.
In competition powerlifting bench press technique, the goal is to shorten the range of motion of the bar while maximizing leg drive. Putting yourself in a big lower back arch and tucking the feet up under you more is the way to do this. Additionally, equipped powerlifters wear bench press shirts that pull the shoulder blades forward, and the humerus into extension past the body. Accordingly, the lifter has to consciously pull the shoulder blades down and back to counteract this tension and not jack up the anterior aspect of the shoulder. After about 20 minutes of searching my laptop, I found this old video of me from 2005 when I was a legit 165-pounder (you can tell by the ostrich legs). Notice the big arch and how much upper back involvement I needed to "fight" the shirt (and, for the record, I was never good at using the shirt...hated those things):
The Average Joe doesn't need to worry about these factors when he's lifting in the gym; he just needs to figure out what gives him the optimal set-up to stay healthy and still benefit from the exercise. Still, I think we can learn a few things from the powerlifting approach.
First, I’m not convinced that such substantial loads for the upper body alone are a good thing. There are smaller joint structures and more mobility than stability than we see in the lower body, which can handle far greater loads. Sharing the load with the lower body tends to better distribute overall training stress. Bringing the feet up on the bench takes this away.
Second, folks are more likely to go into excessive humeral extension (elbows pass the body) in the bottom position with a “sunken” chest. So, they either jack up the anterior aspect of the shoulder there – or the elbows flare out and we deal with a host of other stability issues.
Third, in standing, we actually have a "normal" lordotic curve. I think it's optimal to maintain this lordotic curve on the bench rather than take it away completely. Core stability isn't about cranking someone into excessive extension or flexion; it's about learning how to maintain neutral. A "middle of the road" approach like the one in the videos below is fine for most lifters (you'll notice a slight arch is even more important on the close grip bench press, as there is a greater tendency for humeral extension past neutral when the hands are closer together):
Fourth, there is something to be said about learning from very strong people and their experiences. We learned about how bracing was far superior to hollowing in terms of core stability by simply looking at world class squatters and what they did under insane loads. Along these same lines, you simply don't see world class bench pressers with the feet up and shoulder blades winging out. The flat back posture shifts guys into an abducted scapulae position from the get-go – and it becomes excessive at the top of the press. Internal rotation with protraction closes down the subacromial space and can cause increased rotator cuff impingement as well. A similar thing actually happens when guys have to lift off the racks to themselves to start the lift, and it's one reason why I always recommend getting a bench press handoff.
Fifth, you have to appreciate that the amount of time spent in scapular depression and lumbar extension (if you are even past the point of "neutral") is relatively trivial. If this position provides some extra stability, and doesn't take place for long enough to yield chronic adaptations, I'm all for it.
Hopefully, this brief overview explains why I don't like to have the feet up with bench press technique. If you're looking to learn more, I'd encourage you to check out The Specialization Success Guide, a resource I co-authored with Greg Robins. It features some thorough bench press technique advice, as well as proven bench press specialization strength training programs.
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My "random thoughts" pieces are some of my favorite writings that I've ever published, and today seemed like a good day to throw out some quick and easy ideas on how you can feel better, move better, lose fat, gain muscle, get strong, and - if you're super-motivated - take over the world. Here goes...
1. Get a good training partner.
There are random dudes you meet at the gym who provide a mediocre lift-off on the bench press here and there, and then there are dedicated training partners. There is a big difference. A good training partner will tell you to get your act together and train hard when you're slacking off, or even hold you back when your body is banged up, but you're stupidly trying to push through it. It's guaranteed accountability, motivation, expertise, safety, competition, and all-around awesomeness. To be honest, I often wonder if most people get the best results working with a trainer/strength coach for these factors more than the actual expertise the fitness professional provides!
2. Make your bedroom a cave.
One of the best investments my wife and I made when we bought our new house were reinforced window shades for our bedroom so that very little light could get through when they were down. They make a dramatic difference in terms of how dark you can make your room at night (especially if you have street lights near your residence) and were 100% worth the extra cost, as compared to regular shades.
Even if you don't want to spend the extra few bucks on souped-up shades, though, you can still get some of the benefits of "cave sleeping" by blocking out light from cell phones, alarm clocks, and - if you're a frat boy - bright green neon signs of your favorite beer in your dorm room. Also, do your best to shut the TV and computer off at least thirty minutes before you hit the sack as well, as it'll give your brain time to wind down and transition to some deep, restful sleep.
3. Take Athletic Greens.
I've always been a non-responder to supplements. As an example, I never gained an ounce when I started taking creatine in 2001, and never noticed a huge difference in sleep quality when I started taking ZMA. Still, I pretty much trust in research and go with these supplements, plus mainstays like fish oil and Vitamin D and assume that they're doing their job. It's interesting how some of the most essential supplements we take are the ones where we might notice the most subtle difference, isn't it?
Anyway, in 2011, I added Athletic Greens to this mix. I look at it as whole food based "nutritional insurance" use it in place of my multivitamin. I think it's solid not only as a greens supplement (which, incidentally, doesn't taste like dog crap), but also because it directly improves gut health to improve absorption of micronutrients. With loads of superfoods, herbal extracts, trace elements, antioxidants, and pre- and probiotics, I could tell that it would be something that would decrease inflammation and improve immunity (something I've viewed as increasingly important with each passing year as life has gotten more stressful with the growth of Cressey Performance).
Interestingly, one of our long-time athletes who is now playing baseball at a highly ranked D1 university, started taking Athletic Greens after we chatted about it this summer, and he sent me this note:
Hey Eric, thanks for the recommendation on Athletic Greens. I love the product! I have not gotten sick once since I started taking it 4 months ago, and my body feels better than ever. This is the first semester I haven't gotten sick. Hope all is well!
I guess I'm not the only one who likes it! Check it out for yourself here.
As an aside, they do a pretty cool combination where you can get greens, fish oil, and vitamin D all at once at a great price, and the fish oil is excellent quality. We have several athletes who get everything in this one place for convenience.
4. Go split-stance.
Last week, in my popular post, Are Pull-ups THAT Essential?, I included the following video of forearm wall slides at 135 degrees, a great drill we like to use to train upward rotation, as the arms are directly in the line of pull in the lower traps. With this exercise, we always cue folks "glutes tight, core braced" so that they don't just substitute lumbar extension in place of the scapulae moving into retraction/depression on the rib cage.
Unfortunately, these cues don't work for everyone - particularly those who are super lordotic (huge arch in their lower back). A great "substitute cue" for these folks is to simply go into a split stance, putting one foot out in front of the other (even if it's just slightly). As you have probably observed in performing single-leg exercises like lunges and split-squats, it is much harder to substitute lumbar extension for hip extension than it is with bilateral exercises like squats and deadlifts. Fortunately, the same is true of substituting lumbar extension for scapular movement on the rib cage. So, if you're struggling with the exercise above, simply move one foot out in front of the other and you should be golden.
5. Get some assessments done.
Imagine you were about to embark on a cross country trip with a great vacation in mind in, say, San Diego. However, I didn't tell you where you were starting the journey. While you might get to where you want to be (or at least close to it), it'd make the trip a lot more difficult. You'd probably blow a bunch of money on gas, sleep in some nasty motels in the middle of nowhere, pick up an awkward hitchhiked who smells like cabbage, and maybe even spend a night in a Tijuana jail along the way. Not exactly optimal planning.
A strength and conditioning program isn't much different than this cross-country trip. If you don't know how your body works - both internally and externally - you need to learn before you subject it to serious stress. Get some bloodwork done to see if you have any deficiencies (e.g., Vitamin D, iron, essential fatty acids) that could interfere with your energy levels, ability to recover, or endocrine response to exercise. Likewise, consult someone who understands movement to determine whether you have faulty movement patterns that could predispose you to injury. I think this is one reason why Assess and Correct has been our most popular product ever; it gives folks some guidance on where to start and where to go. Otherwise, the strength and conditioning program in front of you is really just a roadmap, and you don't know where the starting point is.
These are just a few quick thoughts that came to mind today, but I'll surely have many more in the follow-ups to this first installment. Feel free to post some of your own ideas in the comments section below, too!
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Today, we have a guest blog from former Cressey Performance intern Eric Oetter, who is well on his way to a great career in physical therapy. Eric is an extremely bright up-and-comer from whom you'll be hearing a lot in the years to come. Here's a little sampling.
As part of the “pre-launch” phase for his new collaborative project, Elite Training Mentorship, Eric posted an outstanding video covering the lower-extremity assessment protocol he uses at Cressey Performance. For those who haven’t yet seen it, follow the link here; you won’t regret it.
In the video, Eric mentions three different factors that can contribute to mobility deficits at the hip: muscular restrictions, capsular restrictions, and bony restrictions. While the first two – muscular and capsular – can be relatively easy to decipher based on the test position of the hip, identifying bony restrictions can be tricky unless you’ve got access to a client’s radiological imaging. For this reason, it’s important to appreciate any structural variations in the skeletal system that can underlie joint malalignment at the hip.
The focus of this piece is a structural variation called hip anteversion. We’ll be covering the joint morphology associated with anteversion, along with a quick orthopedic test and some implications for programming.
What is hip anteversion?
Excerpted from the 2002 text Diagnosis and Treatment of Movement Impairment Syndromes, Shirley Sahrmann describes hip anteversion as the following:
“ … the angle of the head and neck of the femur is rotated anteriorly, beyond that of the normal torsion with respect to the shaft. The result is a range of medial hip rotation that appears to be excessive, whereas the lateral rotation range appears to be limited.”
Essentially, clients who present with this structural abnormality were born with, or have acquired, a more internally oriented neutral position for their femurs as they sit in the acetabulum (or hip socket). To be classified as anteverted, the femoral head and neck must be rotated more than 15° anteriorly with respect to the plane of the femoral condyles (Sahrmann 2002). (Conversely, a posterior rotation of the femoral head and neck would constitute a retroverted hip.)
When observed standing, clients with hip anteversion will often present with femoral adduction and genu valgum – the classic “knock-kneed” posture. As kids, these clients likely eschewed “indian-style” for W-sitting – a position much more congruent with their natural femoral alignment.
While some might also classify “pigeon-toes” as an indicator for anteverted hips, this is not always the case. In the presence of anteversion, some clients – especially athletes – will develop a tibial torsion as a result of the applied stresses to the lower extremities. This adaptation allows for a neutrally aligned sub-talar joint in the face of morphological changes up the kinetic chain.
The largest implication of hip anteversion or retroversion is a significant discrepancy between hip internal and external rotation. As described in the Sahrmann quotation above, hip anteversion creates an apparently large amount of internal rotation (IR) with a reciprocal loss of external rotation (ER).
I liken these morphological changes to those seen in the retroverted shoulder of an overhead throwing athlete. The total hip range of motion (IR + ER) can present at around 90°, or “normal”, but these measures are drastically skewed in one direction of rotation.
Whereas a retroverted shoulder presents a favorable adaptation in baseball, the same cannot always be said for the athlete with anteverted hips.
If undiagnosed or mismanaged, hip anteversion can create pathology. Expect issues like knee pain, back pain, and hip instability (Sahrmann 2002). For this reason, it’s imperative to recognize anteversion when it presents and apply the programming modifications necessary to accommodate this structural abnormality.
So how can I test for it?
Although checking IR and ER in both supine and prone can highlight limitations in the capsule or surrounding hip musculature, you’ll need an extra orthopedic test at your disposal to clear the skeletal system. For this purpose, we’ll use the Craigs’s test.
Assuming you’re following the assessment outlined in Eric’s video, the best time to perform a Craig’s test is immediately after you’ve assessed a client’s hip rotation in prone, especially if you detect a glaring asymmetry between IR and ER.
Note the client in the photos below – here, we see an excessive amount of IR (~50°) met with limited ER (only ~20°). With a rotational deficit of ≥30°, this client may have some torsional issue at play; thus, a Craig’s test indicated.
With the client remaining in prone the knee held in flexion, the Craig’s test is performed by first palpating the same side greater trochanter, a landmark on the femur that protrudes laterally about 5 inches below the iliac crest. Make sure to apply flat-hand contact with the pads of the fingers – this posture allows for greater sensory feedback and precision. Once this position is assumed, begin internally and externally rotating the femur through its full range of motion.
As you rotate the leg, you’ll notice the greater trochanter tracking against your fingertips, becoming more or less prominent depending on the direction of rotation. Start shortening your oscillations until you determine the position at which the trochanter is most prominent laterally and pause once you locate it. At this range of rotation, the femoral head is optimally situated within the acetabulum.
We get a positive Craig’s test when the hip rotation at the point of ideal femoral alignment is ≥15° into IR. Also, we can now classify the hip as anteverted, providing useful insight for the dexterous coach.
Check out the video below to see a Craig’s test performed on our client from above.
One thing worth noting – a 1992 study by Ruwe et al. showed the Craig’s test to be more reliable than radiological techniques in the assessment of femoral torsion. So, even if you have client X-rays available, a Craig’s test is still worth administering.
If the Craig’s test is positive, how should I alter programming?
Now that we’ve performed a Craig’s test and determined whether or not any torsional qualities exist, it’s time to write an effective program that respects our findings. Here are a few do’s and don’ts to consider when programming:
• DON’T stretch the hip into external rotation – this only creates impingement. We wouldn’t force the retroverted shoulder of a pitcher into an end-range sleeper stretch, so we need to take the same approach with an anteverted hip. Even though the hip is a much more durable joint, there’s no reason to drive motion that a client simply doesn’t have, as this only serves to jam the femoral head against the acetabulum.
• DO increase the amount of core work in clients with femoral torsion. When someone is stuck in internal rotation at the hip, the kinematics of the lower-extremities become predisposed towards a pronation pattern (sub-talar pronation, tibial/femoral IR, and anterior pelvic tilt).
The hip external rotators often become excessively stiff and overused, as they are constantly checking motion into adduction, internal rotation, and flexion. While increasing external rotator strength will improve the first two, we can employ the posterior fibers of external oblique and rectus abdominis to aid in flexion control, creating a more stable pelvis. By doing so, we’re also increasing stiffness at the lumbar spine, fighting any compensatory motion created by the hip external rotation deficit.
As far as exercise selection goes, focus on half-kneeling chops/lifts and anti-extension – both integrate the hips and core simultaneously to check hip flexion ROM. I especially like rollout variations for clients with hip anteversion, which are highlighted in Eric’s video below.
• DON’T introduce quad-dominant lifts until the client shows dramatic improvements in hip stability. The pronation pattern I described above is essentially a cookbook for ACL and MCL injuries. In a population that is likely anteriorly tilted at the pelvis and anterior weight bearing, the last thing we want to do is make them even more reliant on their quads. An adroit posterior chain should precede any anterior chain-focused movement.
• DO hammer the posterior chain as if your life depended on it. While this statement could serve as a mantra for most general population programming, it is even more important when dealing with anteversion of the hip. These clients sometimes present with femoral control so poor, our first goal is to simply get them to baseline.
Mastering stability in the sagittal plane takes precedence. Start bilateral with deadlift and box squat variations and increase stability demands as the client advances. Great second tier progressions include single-leg RDLs, single-leg hip thrusts, and bowler squats, all of which introduce frontal and transverse plane stability.
Lastly, exercises that force the femur into an abducted and externally rotated state are contraindicated – sumo deadlifts provide a great example. Even though pulling sumo is a fantastic variation for hip strength, it can create malalignment in the acetabulum if the hip is anteverted. In this case, it’s safer to stick with either trap bar deadlift or conventional deadlift variations.
Conclusion
Hip anteversion isn’t something you’ll likely see in every client. Johns Hopkins Medical School reports the prevalence to be ~8-10%, but that number varies based upon cultural norms and neurodevelopmental patterns, which can alter skeletal growth.
Regardless, it is an important structural variation to recognize and program for, especially in an athletic population. Taken as supplement to Eric’s lower-extremity video, I hope this article provides you another piece towards building a better assessment.
About the Author
Eric is currently a senior at the University of Georgia majoring in Exercise and Sport Science, with plans to pursue a Doctorate of Physical Therapy. After concluding a Division-1 football career at the Georgia Institute of Technology, Eric has ardently pursued his passion for coaching, garnering experience with clients of all ages and ability levels through internships at both Indianapolis Fitness & Sports Training and Cressey Performance. His articles can be found on EricCressey.com, 8weeksout.com, and in Fighting Fit magazine. You can follow him on Twitter or reach him via email at ecoetter@gmail.com.
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In part 1 of this series, I touched on some of the mechanical factors one must consider in relation to increasing stride length in pitchers. Then, in part 2, I got discussed physical factors – hip mobility and lower-body strength/power – that govern how far you can stride. In wrapping up today with part 3, we’ll work our way up the kinetic chain to discuss three more physical factors that control stride length.
3. Rotary Stability – As I discussed in my recent article at T-Nation, What I Learned in 2011, hip mobility “sticks” better when you have adequate rotary stability, so we’ve been doing more of our core stability exercises in more “extreme” positions of hip mobility.
If you’re going to push the limits of hip abduction, internal, and external rotation range of motion, you need to be sure that you have adequate rotary stability to be stable in these positions in weight-bearing and not destroy the spine. Anybody can just get into these positions in slow speed, but not everyone can control the body precisely with a combination of isometric and eccentric muscle action at the high velocities we see with pitching.
Additionally, many of the big-time long stride guys rely heavily on controlling lumbar spine hyperextension as they ride the back hip down the mound. This is something you’ll see if you watch the deliveries of smaller, athletic guys like Tim Lincecum, Tim Collins, and Trevor Bauer. If they don’t maintain adequate anterior core function, they’ll wind up with extension-based back pain in no time.
4. Thoracic Mobility – Throwing and hitting (and really any rotational challenge like a hockey slapshot or tennis stroke) present a unique challenge to an athlete: the hips and shoulders are temporarily moving in opposite directions. This creates separation, which allows an athlete to store elastic energy and create velocity via the stretch-shortening cycle.
The first issue to consider is that not all separation is created equal. You can create separation with the hips and lower back – and jack up a lumbar spine over time. The goal is to having adequate thoracic spine mobility to ensure that this separation occurs higher up (and engages the upper extremity well).
The second issue is that the more you push the limits of hip mobility, the more you must push the limits of thoracic mobility. We’ve always heard “equal and opposite” when it comes to the throwing arm and glove arm, but the truth is that it probably apply to the lower half and thoracic spine as well. You simply don’t see guys with terrible thoracic mobility getting way down the mound, as that lack of thoracic mobility would cause them to leak forward with the upper body. I covered this in part 1, but the Cliff’s Notes version is that the head doesn’t stay behind the hips long enough, so throwers lose separation.
The third issue is that poor thoracic mobility will really interfere with getting an adequate scap load, so the arm speed will be slower. Throwing with a poorly positioned scapula is like trying to jump out of sand; you just don’t have a firm platform from which to create force.
A very basic thoracic spine mobility drill that would be a “safe” bet for most throwers would be the quadruped extension-rotation.
This drill doesn’t crank the shoulder into excessive external rotation, which may be a problem for the really “loose” arms in the crowd. Progressions for the really stiff pitchers would be the side-lying windmill and side-lying extension-rotation. I also like the yoga plex, a drill I learned from Nick Tumminello, as a means of syncing everything up with a longer stride.
Note: be sure to read this shoulder mobility blog on why not all thoracic spine mobility drills are created equal for throwers!
5. Quick Arm – When I say that you have to have a quick arm to have a long stride, I really just mean that you need some upper body power to make things work. The longer the stride, the quicker your arm must be to catch up in time to create a downward plane and throw strikes.
You simply don’t see guys with long strides competing at high levels unless they have a quick arm that can catch up to the lower body.
When a guy’s arm isn’t quick enough to catch up to his lower half, you see him miss up and arm side.
This type of thrower would be better off shortening up his stride (at least temporarily) and spending more time on good throwing programs to increase arm speed.
This is one reason Justin Verlander is great. If you watch him, he’s not an insanely long stride. Rather, he’s shorter with it, and much stiffer on his landing leg to create an awesome downward plane. Plus, he actually does have a ridiculously quick arm and outstanding secondary stuff. A lot of pitching coaches would try to lengthen his stride – and while this might work, I don’t know about you, but I think overhauling a Cy Young winner’s mechanics is silly.
The “long stride, slow arm” issue is (in my experience) most common in young, lax players who have the joint range-of-motion and just enough stability to get a long stride, but don’t have adequate arm speed to catch up. This is really common in the 14-17 age ranges, and I think it’s one reason why so many of these kids respond incredibly favorably to long toss; it teaches their arms to go faster and keep up with their strides.
Conversely, as you start to deal with 18-year-olds and older (or kids who have grown quickly), you start to see that preparing everything below the arm is arguably more important than arm speed. You don’t pitch in college or professional baseball unless you have a reasonably quick arm, and getting more aggressive with the lower half to stride longer is often exactly what guys need to make the big velocity jump. Likewise, when guys don’t take care of the lower half, but continue on aggressive throwing programs, they often wind up with velocity drops, injuries, or control issues because they’ve lost the separation that made them successful.
Closing Thoughts
While a long stride can certainly be advantageous in the throwing motion, as I've shown in this series, forcing it when you don't have the right physical preparation or mechanical coaching in place can actually hurt an pitcher's performance and health. Remember that the best changes are subtle ones; in other words, you might increase a stride by six inches over the course of a year, not in a single session.
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At Cressey Performance, we're getting to the time of the year when things gradually start to slow down for us. For many business owners, this is a source of frustration, as they worry about paying the bills when things get quieter. I, on the other hand, view it as a source of excitement, as it signifies that the beginning of baseball season is at hand, and our athletes will have an opportunity to put all their off-season hard work into action on the baseball field.
You'd be surprised, however, at how many collegiate and professional players get genuinely worried about how they'll be managed once they get back to school or their organizations. In the private sector, we can individually manage guys with their unique needs in mind, but in collegiate and professional, because of the larger volume of athletes (and fewer coaches per athlete), limited training time, and additional competing demands (i.e., practicing and playing games), player development can be quickly stunted. Believe it or not, 2012 was the first year that Major League Baseball mandated that every minor league affiliate have a strength coach on staff; many teams didn't have anyone (in-person, at least) watching over their highly-touted prospects during critical minor league development periods.
That said, though, there are some colleges and professional organizations who are doing a solid job of managing guys - and I wanted to use today's post to highlight four areas in which they're getting the job done effectively.
1. Synergy - As I outlined in Weight Training Programs: You Can't Just Keep Adding, we have a limited recovery capacity, so if you're going to add something to a program, you have to take something away. Unfortunately, this "give and take" gets overlooked in some team settings. As an example, a strength and conditioning coach, athletic trainer, and pitching coach might all prescribe different rotator cuff exercises for their players without knowing that an overlap is taking place. Or, a strength coach might prescribe a challenging lower body lift, then have a pitching coach send his players to run poles - only to have the head coach tack a very taxing practice on top of an already hefty workload. If you're always adding, but never taking away, it's only a matter of time until athletes break down. As such, communication among coaches, medical and strength and conditioning staffs, and players is absolutely essential for optimal synergy.
2. Individualization - I'm constantly amazed at how - even at the highest levels - players aren't managed on a case-by-case basis. That is, of course, until they get hurt and need unique rehabilitation prescriptions. Just imagine how much less rehabilitation would be needed if players were simply managed more individually on a proactive basis so that injuries didn't occur nearly as often. Additionally, we'd be much more likely to see late-round draft picks and undrafted free agents become MLB superstars if they were managed differently than already-talented players who are just coddled on their way to the big leagues. I think you'd see more stories like Tim Collins'.
I also see this as a huge competitive advantage for college coaches on the recruiting side of things. Not everyone can boast beautiful weather, an amazing baseball complex, a pristine academic reputation, and beautiful girls everywhere when recruiting prospects, but being able to guarantee an individualized approach to development goes a long way in making up the difference.
3. Specificity - You'd be amazed at how many folks in the baseball world have absolutely no knowledge of exercise physiology or the unique demands of baseball - but are still prescribing strength and conditioning programs for baseball players. Some of what I have seen is so atrocious that the players would have been better off doing absolutely nothing. I've seen programs with 10+ mile runs, kipping pull-ups to failure, 1-rep max bench presses, and high rep clean and presses. I seriously can't make this stuff up.
The most common justification for this type of garbage is that coaches want to build mental toughness. Well, I'm here to tell you that there are much better ways of doing that, as your mental toughness won't mean much when your pitchers are having surgeries or throwing 74mph and well on their way to those surgeries.
When we discuss throwing a baseball, we are talking about the single fastest motion in all of sports. General training is absolutely valuable, but if you don't have the specific nature of that throwing motion - and the adaptations it creates - in mind when we implement that general training, you're asking for problems.
4. Effort - The best program on the planet won't do any good if it isn't executed with loads of effort and attention to detail. If you have issues like players skipping warm-ups, athletic trainers refusing to do manual therapy, and coaches showing up late to practice, whatever is written on the paper doesn't matter at all.
At the end of the day, these four factors are just a few of many that will ultimately determine how effective a baseball strength and conditioning program is. Unfortunately, many of these factors are outside of a player's control, so what do you do?
Very simply, control what you can control.
Educate yourself so that you can be your own best coach. Optimize your nutrition and get plenty of sleep. Write down what has and hasn't worked for you so that you can refer back to it down the road and avoid making the same mistakes twice.
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In part 1 of this feature, I talked about how many throwers actually overuse the rotator cuff because they don't appreciate that throwing in itself is a tremendously stressful challenge to the shoulder. I also made the point that cuff timing is more often the problem than cuff strength, so many folks are really training the rotator cuff incorrectly with thousands of reps of band exercises. Let's examine that in a bit more depth.
First, I should preface this piece by saying that I think there are definitely places for utilizing bands to strengthen the rotator cuff in a baseball training context. They obviously provide outstanding convenience for on-field work and travel circumstances, as well as scenarios where players may not have qualified professionals at hand to help with manual resistance work and rhythmic stabilizations. Some cuff work is better than no cuff work! Additionally, many players swear by bands during the warm-up phase to help with getting blood flow to the shoulder complex with a bit of activation at the same time.
However, there are two primary issues with relying exclusively on bands:
1. In an external rotation variation, the resistance is actually greatest at the point (near maximal external rotation) where the athlete is weakest. In other words, the band doesn't ideally accommodate the strength curve. This is a huge concern for me, as one of the biggest things I notice in athletes is that when training in a position of somewhat significant external rotation, they can't "pick up" the resistance quickly enough. More on this later.
2. Most people simply overlook eccentric control. This is something that is coachable, no doubt, but most people do band exercises for so many reps per set that the athlete can quickly lose focus and resort back to bad habits.
As you can imagine, these are shortcomings that also exist - albeit to a slightly lesser extent - with cable and dumbbell/plate external rotation rotator cuff strength exercises:
So, how do we overcome these shortcomings while helping to address rotator cuff timing? You have two great options.
1. Rhythmic Stabilizations
The true role of the rotator cuff is to stabilize the humeral head (ball) in the glenoid fossa (socket). And, during throwing, it does a ton of work, as the humerus goes through extreme ranges of motion in all three planes. Rhythmic stabilization drills are a great way to train the cuff to fire quicker, and they're particularly valuable because you can train them at various points in the range of motion, modifying the challenge depending on how stable an individual is in a given position. Plus, this is an outstanding way of monitoring cuff function over the course of weeks and months with athletes you see regularly; regular improvements are easily perceived.
You'll notice that I don't crank him back to extreme external rotation in this video; rather, we stop short of it and just assume that we'll get some carryover in stability a bit further (as per previous research on carryover of isometric exercise).
The sky is really the limit in terms of how you train this one; we have about a dozen variations that we use on a daily basis. A few quick guidelines:
a. The more congenital or acquired laxity an athlete has, the less aggressive you'll want to be with your perturbations. When someone is less proficient, gently destabilizer, and apply the prturbations closer to the shoulder. When someone is more stable, perturbate a bit more firmly, and apply it further down the arm.
b. I sometimes start those with significant laxity with closed chain exercises so that they can draw some stability from the floor or wall.
c. Make sure that the scapula is positioned appropriately; it certainly shouldn't be protracted, but don't crank it into excessive retraction, either. Just keep it from winging off the rib cage.
d. I like 2x/week rhythmic stabilizations during off-season training. We typically integrate it between sets on lower-body strength training days.
2. Manual Resistance External Rotations
These drills are "where it's at." On one hand, they are the best strength-building exercise for the cuff because they train it in its most function context: eccentric control. However, more specific to today's point, they are great for improving cuff recruitment at the most vulnerable point in the throwing motion: lay-back.
When we do a drill like this, I encourage the athlete to "pick it up early." In other words, I won't apply downward pressure (eccentric overload) until they apply some external rotation force into my hand).
Some quick guidelines for manual resistance external rotations:
a. Emphasize eccentric overload, but make sure you aren't pushing all the way down, as most people will go into scapular anterior tilt as they are more internally rotated. Pushing someone all the way down puts the shoulder in a pretty vulnerable position, as scapular stability is lost and the subacromial space is closed down.
b. Given that you have to apply the force further down the arm, make sure that the athlete isn't cheating by just utilizing the wrist extensors.
c. In the manual resistance external rotations at 90 degrees in the scapular plane, your other hand should "cup" the elbow to make sure that the rotation is taking place at the shoulder (as opposed to horizontal adduction/abduction).
d. I like to utilize manual resistance external rotations twice a week during the off-season, usually toward the end of upper body strength training sessions. We'll use less manual resistance work in this regard, though, when guys start to ramp up their throwing, as it tends to create a bit more soreness.
In a recent presentation in front of a bunch of baseball coaches, I made the following statement - and it turned a lot of heads:
I think most people overtrain the rotator cuff nowadays, and they do so with the wrong exercises, anyway.
To illustrate my point, I'm going to ask a question:
Q: What is the most common complication you see in guys as they rehabilitate following a Tommy John Surgery?
A: Shoulder problems - generally right around the time they get up to 120 feet.
Huh? Shoulder pain is a post-operative complication of an elbow surgery? What gives?
First, I should make a very obvious point: many of these guys deal with shoulder stiffness as they get back to throwing simply because they've been shut down for months. That I completely expect - but remember that it's stiffness, and not pain. They always throw their way out of it.
The more pressing issue is what is taking place in their rehabilitation - and more specifically, what's taking place with the synergy between their rehabilitation and throwing program. Let me explain.
Rehabilitation following a UCL reconstruction is extensive. While different physical therapists certainly have different approaches, it will always be incredibly heavy on rotator cuff strength and timing, as well as adequate function of the scapular stabilizers. Guys always make huge strides on this front during rehab, but why do so many have shoulder pain when they get further out with their long tossing? The answer is very simple:
Most people don't appreciate that throwing a baseball IS rotator cuff training.
Your cuff is working tremendously hard to center the humeral head in the glenoid fossa. It controls excessive external rotation and anterior instability during lay-back.
It's fighting against distraction forces at ball release.
And, it's controlling internal rotation and horizontal adduction during follow-through.
Simultaneously, the scapular stabilizers are working incredibly hard to appropriately position and stabilize the scapula on the rib cage in various positions so that it can provide an ideal anchor point for those rotator cuff muscles to do their job.
A post-op Tommy John thrower - and really every player going through a throwing program - has all the same demands on his arm (even if he isn't on the mound, where stress is highest). And, as I wrote previously in a blog about why pitchers shouldn't throw year-round, every pitcher is always throwing with some degree of muscle damage at all times during the season (or a throwing program).
Keeping this in mind, think about the traditional Tommy John rehabilitation approach. It is intensive work for the cuff and scapular stabilizers three times a week with the physical therapists - plus many of the same exercises in a home program for off-days. They're already training these areas almost every day - and then they add in 3-6 throwing sessions a week. Wouldn't you almost expect shoulder problems? They are overusing it to the max! This is a conversation I recently had with physical therapist Eric Schoenberg, and he made another great point:
Most guys - especially at higher levels - don't have rotator cuff strength issues; they have rotator cuff timing issues.
In throwing - the single-fastest motion in all of sports - you're better off having a cuff that fires at the right time than a cuff that fires strong, but late. Very few rotator cuff exercise programs for healthy pitchers take that into account; rather, it's left to those doing rehabilitation. Likewise, most of the programs I see altogether ignore scapular stability and leave out other ways to train the cuff that are far more functional than just using bands.
Now, apply this example back to the everyday management of pitchers during the season. Pitchers are throwing much more aggressively: game appearances, bullpens, and long toss. They need to do some rotator cuff work, but it certainly doesn't need to be every day like so many people think.
I'll cover how much and what kind in Part 2. In the meantime, if you'd like to learn more about the evaluation and management of pitchers, check out Optimal Shoulder Performance.
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The prone external rotation is a strength exercise for the posterior rotator cuff that we've added to our strength and conditioning programs over the past few months with good success. And, while the primary goal is to increase shoulder stability via improved rotator cuff function, the truth is that this drill also served as a motor control exercise to reeducate folks on what should be moving and when.
We use this drill a lot with guys who are in a dramatic anterior pelvic tilt, and start everything with the "gluteus tight, core braced" cues. Effectively, this means that you force the athlete to actually externally rotate the shoulder instead of simply arching through the lower back to get to the desired "finish" point. You'll be amazed to see how many athletes have significantly less "observable external rotation" when they are locked into neutral spine.
You also want to cue the athlete to keep the scapula (shoulder blade) on the rib cage, but he/she doesn't need to be aggressively pulled into scapular retraction in order to get there.
Once the scapula is set, I tell athletes to think about getting the ball to rotate in the socket without allowing the head of the humerus to slide down toward the table. This is a very important cue, as many athletes will allow excessive anterior migration of the humeral head during external rotation exercises; we want them to learn to keep the ball centered in the socket. If an athlete is really struggling with this, we may place a rolled up towel or half-roller underneath the anterior shoulder as feedback on where things should be.
Very rarely will we load this up, and in the rare instances we do, it wouldn't be for more than 2.5 -5 pounds. The shoulder is a joint with a broad range of movements that mandate a lot of dynamic stability, so we want to make sure things are working perfectly.
I'll generally include this movement in the warm-ups for sets of eight reps - or we may use it as a filler on a lower-body day between sets of more compound strength exercises. It can also serve as a great follow-up to shoulder mobility drill geared toward improving external rotation, as this is an avenue through which you can add stability to the range-of-motion you're creating.
Give it a shot in your strength and conditioning programs and then let me know how it goes in the comments section below!
Today, I'll wrap up my "Best of 2011" series by highlighting the pieces that I enjoyed creating. Check them out:
1.11 Years, 11 Lessons, 100 Pounds - This T-Nation article recapped my long journey in the strength and conditioning world to get to where I am. It was definitely one of my most popular articles of all time at T-Nation.
2. The Fitness Business Blueprint - This product was a blast to create because I think it filled a gaping hole in the market. Until we launched it, nobody had created a fitness business product that didn't just discuss how to grow a business, but also how to improve as a trainer/coach. I had a blast collaborating with Pat Rigsby and Mike Robertson on it.
3.What I Learned in 2010 - I enjoy writing these articles every year, because they serve as a great opportunity to revisit some of the most valuable lessons from the previous year. And, as the saying goes, the best way to master something is to teach it to others.
4. Strength and Conditioning Program Success: The Little Things Matter - This was a fun blog to write, as I did so right around the time when several of our athletes were recognized for some awesome achievements. It gave me a chance to reflect on why they were successful - and why many other folks aren't. There will be some valuable takeaways for you, regardless of your athletic or fitness goals.5. Oblique Strains in Baseball: 2011 Update - I'd written about oblique strains in the past, but they continue to be the big fat white elephant in the corner that is being ignored in the context of baseball development. Hopefully this article got some people to start paying attention to the fact that it's just the fallout of a lot of things that are wrong with the current approaches being employed with respect to baseball strength and conditioning.
6. The IYCA High School Strength and Conditioning Coach Certification - I was fortunate to be a contributor on this awesome resource that will hopefully change the tide of how high school athletes are trained. Based on the feedback we've received thus far, it's already helped tremendously in this regard.
7. Strength Training Program Success: How Dr. P did at 47 What He Couldn't Do at 20 or 30 - This blog (and accompanying video) were awesome because our entire gym got involved on this goal - and were there to see our good friend accomplish it.
8. The Everything Elbow In-Service - This was an in-service I filmed for our staff this summer to prepare them for all the elbow issues that may come through our doors. It lasted 32 minutes, and sold far better than I would have imagined - and led to a lot of requests for us to continue filming staff in-services and making them available for sale.
9. Strength and Conditioning Programs: Think the Opposite - This has a few tips about a counterintuitive way to achieve success in training and in business.
10. Hip Pain in Athletes: The Origin of Femoroacetabular Impingement - FAI is becoming more and more common (especially in young athletes), and in this blog, I talk about some of the reasons why.
That wraps up our "Best of 2011" series. Thank you very much for your support of EricCressey.com in 2011; I'm looking forward to making 2012 even more memorable!
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In continuing with our "Best of 2011" theme to wrap up the year, today, I've got the top EricCressey.com videos of the year.
The Cressey Performance Elite Baseball Development Video - This was something that we needed to do simply to outline how we approach off-season development for our baseball clients, but it ended up being a lot of fun to be a part of, as a lot of the staff and athletes took a genuine interest in how it'd turn out. A special thanks goes out to Matt and Jamie at Lasting Memories Videotaping for making it happen.
Tyler Beede Draft Reaction - This was a fun night not just because of the obvious excitement of having 120 people at your house (yes, this is my living room), but because it was awesome just to appreciate just how far Tyler had coming as a person and an athlete since he started training with us back in 2008.
How to Create a Real Strength and Conditioning Program - This is one of the webinars I created around the re-launch of Show and Go back in October.
How to Create an Imbalanced Strength and Conditioning Program that Works - I released this webinar just a few weeks after the first one, as I was feeling the "webinar mojo" and this had been a topic I'd want to cover for quite some time.
Those were my top five videos of the year, but there were definitely plenty more you may have missed. Luckily, you can check them out on my YouTube Channel.
I'll be back tomorrow with one last "Best of 2011" feature.
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